James A. Fain, Ph.D., RN, BC-ADM, FAAN, associate dean for academic affairs at the Graduate School of Nursing at the University of Massachusetts Medical School in Worcester, Mass. Fain is editor-in-chief of The Diabetes Educator, and his professional memberships include the American Association of Diabetes Educators, the American Diabetes Association, the American Nurses Association and Sigma Theta Tau International. He is a fellow in the American Academy of Nursing.
Q. When did you decide to pursue a career in nursing and why?
A. My decision to pursue a career in a health profession occurred while in high school. I became more interested in nursing after talking with a friend of the family who was a nurse anesthetist. He described the many opportunities to interact with patients and health professionals on a daily basis. I wanted to make a difference in people’s lives and believed nursing would afford me such opportunities along with career advancement.
Q. Why did you decide to pursue diabetes nursing?
A. My career as a diabetes educator began when I graduated from the master’s degree program at the University of Alabama in Birmingham, School of Nursing. Upon graduating, I took a position at the University Hospital on an inpatient unit as a diabetes clinical nurse specialist and had the good fortune of working with great colleagues who were responsible for introducing me to the American Association of Diabetes Educators (AADE). After working a couple of years in Alabama, I returned to the northeast and began my career in academia while continuing to work as an inpatient/outpatient diabetes educator. During the first half of my years in academia, I maintained a clinical practice as an outpatient diabetes educator. In addition, my role as researcher/scientist began to focus on conducting several investigated initiated research studies in the area of diabetes self-management.
Q. What are the primary roles and responsibilities of a diabetes nurse educator?
A. Diabetes educators are healthcare professionals (e.g., nurses, dietitians, pharmacists, physicians, psychologists, exercise physiologists) who have experience, knowledge and skills in the care of people with pre-diabetes and diabetes. Diabetes educators are an integral partner in the diabetes care team, providing diabetes self-management education (DSME). Specific responsibilities include providing nutritional therapy (healthy eating), exercise planning (being active), adjusting type and dosage of medication (taking medication), teaching blood glucose monitoring, and providing behavioral and psychosocial counseling (healthy coping and reducing risks).
Q. Why do you think the role of a diabetes nurse educator is so important?
A. Currently, 29 million Americans – or approximately 9.3 percent of the population – have diabetes, and another 86 million people over the age of 20 have pre-diabetes, a condition that increases risk for diabetes. The role of the diabetes educator is critical in providing self-management training/education and diabetes self-management support (DSMS) to those with diabetes and pre-diabetes.
Q. What do you see for the future of diabetes nursing?
A. I would encourage new diabetes educators to think outside of the box in order to reach more individuals with pre-diabetes and diabetes and help them achieve better health outcomes. Thinking outside of the box allows diabetes educators to become comfortable with new roles such as entrepreneurs, marketers, behavioral change agents and coaches. Going forward, diabetes educators should explore each of these new roles using their position and expertise in the field of diabetes education.
Q. What are some of the challenges and rewards of caring for patients with chronic disease?
A. Several challenges lie ahead for diabetes educators, particularly as we struggle with trends driving practice (e.g., rising healthcare costs, competition, issues related to payment/reimbursement, diabetes education being conducted in non-traditional settings). Whatever the challenge, we must embrace them all and be proactive – attempt to do things differently while educating others on the value of diabetes education. One of the more important options in dealing with challenges associated with chronic disease is to formally recognize the field of diabetes education and diabetes educators as health professionals committed to focusing on education/training of people with (or at risk for) diabetes.